The present invention relates to a system for repairing lacerated or severed soft tissue structures of the body, particularly connective cords such as tendons.
Repair techniques for lacerated or severed tendons vary widely depending on the nature of the injury and the particular tendon affected. There are large differences in the extent to which access can be obtained in the least obtrusive manner, in the amount of tendon excursion, in the surrounding environment, in the stresses to which different tendons are normally subjected, and in the healing characteristics of different tendons. In addition, often there is no consensus of the overall best way to repair a given tendon.
For example, repair of a long flexor tendon in the hand that has been severed is typically achieved by suturing the severed tendon ends face-to-face. Historically, the joints across which the tendon acts were immobilized for from three to eight weeks to protect the tendon while it healed, because a freshly sutured tendon can withstand only a fraction of the tensile force to which a healthy tendon is subjected during normal use. Immobilization results in scarring and adhesion formation along the length of the tendon. Range of motion is adversely affected, particularly in the case of flexor tendons which normally glide smoothly through and over the unique system of tendon tunnels and pulleys of the hand. Nevertheless, it was thought that fibroblastic ingrowth was required in order for the tendon to heal, such that immobilization and the resulting decreased range of motion were considered necessary evils in order for effective healing to take place. More recently it has been discovered that flexor tendons have an intrinsic capacity to heal and that early motion may actually expedite healing. Still, exercises must be carefully planned and carried out due to the weakness of the sutured repair. In early stages of healing, protected passive and/or restricted active exercises may be used, followed by tendon gliding and active strengthening exercises in later stages. The affected joints are most often partially immobilized to prevent inadvertent application of excess force.
The present invention is concerned with a system for repair of injured soft tissue structures, particularly connective cords such as tendons, by use of adhesive and, preferably, reinforcing members or stents which can be made of substantially rigid or semi-rigid material. Such stents are adapted for extending longitudinally between severed end portions of a tendon with the severed end portions in abutting relationship. The tendon is secured to the stent by the adhesive such that tension applied to the tendon is transmitted through the stent. The stent and adhesive maintain the severed tendon ends abutting as tension is applied to the tendon.